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Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy

Background: The therapeutic strategy for mitral regurgitation (MR) in patients with advanced heart failure and wide QRS complex who are indicated for both intervention to MR and cardiac resynchronization therapy (CRT), remains unclear. Objective: We aimed to determine electrocardiogram parameters th...

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Autores principales: Kataoka, Naoya, Imamura, Teruhiko, Koi, Takahisa, Tanaka, Shuhei, Fukuda, Nobuyuki, Ueno, Hiroshi, Kinugawa, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147072/
https://www.ncbi.nlm.nih.gov/pubmed/35621870
http://dx.doi.org/10.3390/jcdd9050159
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author Kataoka, Naoya
Imamura, Teruhiko
Koi, Takahisa
Tanaka, Shuhei
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
author_facet Kataoka, Naoya
Imamura, Teruhiko
Koi, Takahisa
Tanaka, Shuhei
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
author_sort Kataoka, Naoya
collection PubMed
description Background: The therapeutic strategy for mitral regurgitation (MR) in patients with advanced heart failure and wide QRS complex who are indicated for both intervention to MR and cardiac resynchronization therapy (CRT), remains unclear. Objective: We aimed to determine electrocardiogram parameters that associate with MR reduction following CRT implantation. Methods: Among the patients with advanced heart failure and functional MR who intended to receive CRT implantation, baseline QRS morphology, electrical axis, PR interval, QRS duration, and averaged S-wave in right precordial leads (V1 to V3) in surface electrocardiogram were measured. The impact of these parameters on MR reduction following CRT implantation, which was defined as a reduction in MR ≥1 grade six months later, was investigated. Results: In 35 patients (median 71 years old, 18 men), 17 (49%) achieved an MR reduction following CRT implantation. Among baseline characteristics, only the higher S-wave amplitude in right precordial leads was an independent predictor of MR reduction (odds ratio 14.00, 95% confidence interval 1.65–119.00, p = 0.016) with a cutoff of 1.3 mV calculated through the area under the curve. The cutoff significantly stratified the cumulative incidences of heart failure re-admission and percutaneous mitral valve repair following CRT implantation (p = 0.032 and p = 0.011, respectively). Conclusions: In patients with advanced heart failure and functional MR, the baseline higher amplitude of S-wave in the right precordial leads might be a good indicator of MR improvement following CRT.
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spelling pubmed-91470722022-05-29 Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy Kataoka, Naoya Imamura, Teruhiko Koi, Takahisa Tanaka, Shuhei Fukuda, Nobuyuki Ueno, Hiroshi Kinugawa, Koichiro J Cardiovasc Dev Dis Article Background: The therapeutic strategy for mitral regurgitation (MR) in patients with advanced heart failure and wide QRS complex who are indicated for both intervention to MR and cardiac resynchronization therapy (CRT), remains unclear. Objective: We aimed to determine electrocardiogram parameters that associate with MR reduction following CRT implantation. Methods: Among the patients with advanced heart failure and functional MR who intended to receive CRT implantation, baseline QRS morphology, electrical axis, PR interval, QRS duration, and averaged S-wave in right precordial leads (V1 to V3) in surface electrocardiogram were measured. The impact of these parameters on MR reduction following CRT implantation, which was defined as a reduction in MR ≥1 grade six months later, was investigated. Results: In 35 patients (median 71 years old, 18 men), 17 (49%) achieved an MR reduction following CRT implantation. Among baseline characteristics, only the higher S-wave amplitude in right precordial leads was an independent predictor of MR reduction (odds ratio 14.00, 95% confidence interval 1.65–119.00, p = 0.016) with a cutoff of 1.3 mV calculated through the area under the curve. The cutoff significantly stratified the cumulative incidences of heart failure re-admission and percutaneous mitral valve repair following CRT implantation (p = 0.032 and p = 0.011, respectively). Conclusions: In patients with advanced heart failure and functional MR, the baseline higher amplitude of S-wave in the right precordial leads might be a good indicator of MR improvement following CRT. MDPI 2022-05-16 /pmc/articles/PMC9147072/ /pubmed/35621870 http://dx.doi.org/10.3390/jcdd9050159 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kataoka, Naoya
Imamura, Teruhiko
Koi, Takahisa
Tanaka, Shuhei
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
title Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
title_full Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
title_fullStr Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
title_full_unstemmed Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
title_short Impact of S-Wave Amplitude in Right Precordial Leads on Improvement in Mitral Regurgitation following Cardiac Resynchronization Therapy
title_sort impact of s-wave amplitude in right precordial leads on improvement in mitral regurgitation following cardiac resynchronization therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147072/
https://www.ncbi.nlm.nih.gov/pubmed/35621870
http://dx.doi.org/10.3390/jcdd9050159
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